Visceral leishmaniasis: a cause of pyrexia of unknown origin

Objective: To determine the cause of pyrexia of unknown origin

Study Design: Cross-sectional study

Setting: The subjects for this study were enrolled at the private setup in northern areas of Gilgit and Hyderabad from January 2006 to December 2007

Method and Material: All patients presenting with pyrexia unresponsive to antibiotic and antimalarial therapies with negative serology for salmonella, malaria, tuberculosis and brucellosis underwent bone marrow aspiration. The specimens were analyzed at Armed Force Institute of Pathology [AFIP] Rawalpindi and Department of Pathology, Liaquat University of Medical and Health Sciences [LUMHS] Jamshoro. Patients were treated on the basis of microscopic findings and observations were recorded

Result: Among total 77 subjects 72 [98.51%] were of <8-years age and 5 [6.49%] were of 8-25 years age. Males were 53 [68.83%] and females were 24 [31.17%]. Microscopic examination reported all 77 specimens as amastigote positive. Subjects became symptom-free after anti-leishmaniasis therapy

Conclusion: Patients belonging to the Northern areas and Azad Kashmir living anywhere in Pakistan, not responding to antibiotics and antimalarial treatment with negative serology for salmonella, brucellosis, tuberculosis and malaria should be considered for visceral leishmaniasis and be investigated and treated promptly

Pattern of dengue virus infection cases admitted in tertiary care hospital at Hyderabad, Sindh

Objective: To find out the pattern of Dengue virus infection in patients who presented with fever

Study Design: Prospective observational study

Setting: This study was conducted at Research and Diagnostic Laboratory, Liaquat University of Medical and Health Sciences at Hyderabad. Sindh from November 2006 to December 2006

Methods: During this period all blood samples from 173 patients, suspected to be suffering from dengue fever, dengue hemorrhagic fever and/or dengue shock syndrome, were received and tested for dengue IgM and IgG antibodies. Complete blood counts were also done. Patients with history of headache, retro-orbital pain, arthralgia, rash, and hemorrhagic manifestations, having leucopenia and thrombocytopenia were included in the study

Results: Most of the patients positive for dengue IgM antibodies were between the age group of 14-years to 50-years [49 males and 12 females]. Out of 173 samples 28 were positive for dengue IgM [primary infection] and 21 were positive for dengue IgG [secondary infection]. While 12 patients found to have late primary and early secondary response with both dengue IgM and IgG antibodies

Conclusion: Dengue fever presented in all three patterns in Sindh province; males predominated mostly with primary infection

Hepatitis-B surface antigen [HBSAG] screening and vaccination experience in Tharparkar

Hepatitis B is a very common communicable viral disease due to multiple uses of syringes and infusions, unsafe blood transfusions. Tharparkar desert where doctors and health facilities are less as compare to other parts of Sindh Province, a study based on proforma filled during free hepatitis B vaccination and Hepatitis B surface antigen [HBsAg] tests, conducted with the sponsorship of pathologist and philanthropists In two towns [Naukot and Chalhar total population of 10,000] of Tharparkar desert selected for this services during January 2005 to January2006. Total 612 residents of theses towns were enrolled for screening and and vaccination services of Hepatitis B out of 612, residents 321 were male 291 were female their age was ranging, from less than 10 years to more than 60 years. The HBsAg surface antigen was positive in 45 males and 28 females showing 73 out of 539 +ve cases giving HbsAg positive rate 11.9%. which is more than the national average of 10%. Study found early adolescence and teenagers showed high carrier rate. This is an alarming situation and needs urgent remedlal steps to prevent this growing problem HBV Vaccine in EPI is showing positive results and children below 10 are showing low infection rate than adults showing and adolescent ages

Epidemic of cutaneous leishmaniasis in Taluka Johi, District Dadu, Sindh

The objective of the study was to investigate the epidemic of Cutaneous Leishmaniasis in Dadu District where this disease first emerged in 2002, and still is continuing in the district till the data of the study was collected in Oct. - Dec. 2004. A descriptive study with a total of 236 cases registered for various skin diseases in Taluka Johi District Dadu. Of these 108 cases were diagnosed as Cutaneous Leishmaniasis Place of work: Taluka Hospital Johi during October - December 2004. The highest sufferers from the Cutaneous Leishmaniasis were children and women. The upper limb was found 39.6% of the total lesions of the body while face, eyelids were 27.8% of the total lesions. There is a disease Epidemic form of Cutaneous leishmaniasis and more remedial measures are recommended as it is still a Public Health Problem